PORTLAND, Ore. – You trust your doctor to give you the latest unbiased care but drug companies are giving payments, travel and other perks to local doctors, including dozens at the only medical school in Oregon.
A KATU News On Your Side investigation looked at why Oregon Health and Science University hasn’t followed the lead of Harvard and Stanford to ban the practice critics call "medical marketing."
Fourth-year medical student Lee Shapley is taking on OHSU, the same university that's about to make him a doctor. He started an online petition titled: "Stop allowing your physicians to participate in speaker's bureaus."
"Speaker's bureau" is the term used when doctors are paid by the pharmaceutical industry to give speeches on behalf of their drugs.
"I feel like this presents a conflict of interest that is problematic for everyone who is learning from those faculty, and I think it's also a conflict of interest for patients," Shapley said.
Even before medical school, Shapley began to believe patients could be getting biased health-care decisions through speaker's bureaus. He was in a position to know, because he was employed by a pharmaceutical company to work on paid presentations for doctors.
Shapley launched his petition after the publication of a "Dollars to Docs" report in September, showing $761.3 million in recent payments to doctors nationwide by a dozen pharmaceutical companies.
In the state of Washington, doctors earned nearly $12 million. In Oregon, nearly $6 million was paid to 291 doctors – 61 of them to varying degrees teach, do research or work at OHSU.
"Physicians have lots of different ways to receive this data now as opposed to going to a dinner or going to a ski resort in order to receive a presentation from another physician," said Shapley.
"The concept of being thought of as a marketer for the company is somewhat offensive," said Dr. Alan Sandler, a well-known lung cancer specialist at OHSU. "And I think it is more of an information dissemination. I think that's a fair statement."
Sandler is No. 2 on the list of OHSU doctors in pharmaceutical earnings – more than $100,000 for travel and consulting, but mostly for speaking.
Sandler said he's saving lives by sharing information the best way possible: face to face about treatments he's studied, which other specialists wouldn't otherwise know about.
"I'm talking about a drug that actually has no competitor, because it's only used for this genetic mutation," he said. "But if I go and give a talk, and I find out the next week some physician tested a patient and gave the drug to a patient, I consider that a success. That's what it's all about, although it could be twisted and turned: Oh, Sandler is just marketing for the company. See, he goes and gives a talk and more people use the drug."
OHSU ethics rules say its doctors must have the final say over the content of their speeches that are prepared by pharmaceutical companies. They must declare any payments over $10,000 in a year. That will soon change to $5,000.
"It's a continuum, and there are going to be some folks that are very restrictive and there are going to be some that are on the other end of the spectrum. But I think that most reasonable centers are going to be probably somewhere in the middle and that's where I would put us," Dr. Ron Marcum, a OHSU compliance and ethics officer, said when asked why OHSU isn't doing the same as Harvard and Stanford.
"A pharmaceutical company who is in the business to make profits would not continue to pay multiple thousands of dollars for a physician to come and speak on behalf of that product if this wasn’t effective. And if this wasn't a good marketing tool," said Shapley.
One in five of his fellow students agreed with him by signing his petition.
OHSU said it is constantly reviewing its rules on this issue. Next year a new federal law requires all pharmaceutical companies to disclose all payments to doctors.
- Next year a new federal law requires all pharmaceutical companies to disclose all payments to doctors. ABA Health eSource
- Read the full Dollars to Docs report produced by independent journalists at ProPublica